Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0038002 (splenomegaly)
 9,873 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Transfused platelets (plts) are either pooled random-donor platelet (plt) concentrates or single-donor apheresis plts. When stored for 5 days, all of these products are equally efficacious. A 10,000/microL prophylactic plt transfusion trigger has been documented to be both hemostatically efficacious and cost effective in reducing plt transfusion requirements. The optimal plt dose/transfusion is being evaluated in an ongoing clinical trial. Therapeutic plt transfusions to control or prevent bleeding with trauma or surgical procedures require higher transfusion triggers of 100,000/microL for neurosurgical procedures and between 50,000/microL and 100,000/microL for other invasive procedures or trauma. Leukoreduction has been documented to reduce plt alloimmunization rates, cytomegalovirus (CMV) transmission by transfusion, and febrile transfusion reactions. Whether it reduces immunomodulatory effects of transfusion (i.e., decreases infection rates and cancer recurrence) is still controversial, as is universal leukoreduction. Poor responses to plt transfusions are often multifactorial. For alloimmune plt refractoriness, HLA matching, cross-matching, and identification of the specificity of the patient's antibodies with avoidance of mismatched donor antigens are all equally effective in identifying compatible plts for transfusion. Other causes of poor plt responses are splenomegaly, ABO mismatching, females with 2 or more pregnancies and males, use of heparin or amphotericin, bleeding, fever, graft-vs-host disease (GVHD), and vaso-occlusive disease (VOD).
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PMID:Evidence-based platelet transfusion guidelines. 1802 26

A Japanese male in his 70s with chronic hepatitis C was diagnosed with diffuse large B-cell lymphoma and achieved and maintained complete remission following treatment with eight cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, and prednisolone). Seven years later, he received the direct-acting antivirals (DAAs) sofosbuvir/ledipasvir for hepatitis C virus (HCV) genotype 1b. Although the patient achieved sustained virological response immediately after the initial treatment period, laboratory data showed elevation of LD and soluble IL-2R. Computer tomography showed diffuse intraabdominal lymph node swelling and splenomegaly. Lymph node biopsy revealed the relapse of lymphoma. The lymphoma cells were resistant to chemotherapy, and the patient died five months later. Several studies reported early recurrence of hepatocellular carcinoma after HCV treatment using DAAs. However, the relationship between DAAs and hepatocellular carcinoma recurrence remains unclear. Nonetheless, possible cancer recurrence should be considered in patients with a history of lymphoma who are prescribed DAAs to treat HCV.
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PMID:[Recurrence of malignant lymphoma immediately after treatment for hepatitis C virus using direct-acting antivirals]. 3074 56